Internet gaming disorder (IGD) has been proposed as a behavioral addiction warranting additional investigation. Craving is considered a core component of addictions. However, few studies to date have investigated craving in IGD. In the current study, we investigated how gaming was associated with changes in response to gaming-related stimuli in IGD subjects and those with recreational game use (RGU).
Behavioral and fMRI data were collected from 27 individuals with IGD and 43 with RGU. Subjects’ craving responses to gaming-related stimuli were measured before and after 30 minutes of gaming.
The comparison between post- and pre-gaming measures showed that, for IGD, gaming was associated with increased craving and increased brain activation of the lateral and prefrontal cortex, the striatum, and the precuneus when exposed to gaming-related stimuli. In individuals with RGU, no enhanced brain activity was observed.
These results suggest that gaming behavior enhances craving responses in IGD but not in RGU subjects, provide insight into potential mechanisms underlying IGD and suggest behavioral and neurobiological targets for IGD-related interventions.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Publishing,
Arlington, VA; 2013.
- Sayette, M.A. The Role of Craving in Substance Use Disorders: Theoretical and Methodological Issues. Annu Rev Clin Psycho. 2016;12:407–433.
- Sinha, R., Li, C.S. Imaging stress- and cue-induced drug and alcohol craving: association with relapse and clinical implications. Drug Alcohol Rev. 2007;26:25–31.
- Potenza, M.N., Steinberg, M.A., Skudlarski, P. et al, Gambling urges in pathological gambling: A functional magnetic resonance imaging study. Archives of General Psychiatry. 2003;60:828–836.
- Potenza, M.N., Balodis, I.M., Franco, C.A., Bullock, S., Xu, J., Chung, T. et al, Neurobiological considerations in understanding behavioral treatments for pathological gambling. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors. 2013;27:380–392.
- Grant, J.E., Kim, S.W., Hollander, E., Potenza, M.N. Predicting response to opiate antagonists and placebo in the treatment of pathological gambling. Psychopharmacology (Berl). 2008;200:521–527.
- Engelmann, J.M., Versace, F., Robinson, J.D., Minnix, J.A., Lam, C.Y., Cui, Y. et al, Neural substrates of smoking cue reactivity: A meta-analysis of fMRI studies. NeuroImage. 2012;60:252–262.
- Tiffany, S.T. A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. Psychological review. 1990;97:147–168.
- Sayette, M.A., Schooler, J.W., Reichle, E.D. Out for a smoke: the impact of cigarette craving on zoning out during reading. Psychological science. 2010;21:26–30.
- Dong, G., Potenza, M.N. Risk-taking
and risky decision-making in Internet gaming disorder: Implications
regarding online gaming in the setting of negative consequences. Journal of psychiatric research. 2016;73:1–8.
- Wilson, S.J., Delgado, M.R., McKee, S.A., Grigson, P.S., MacLean, R.R., Nichols, T.T. et al, Weak ventral striatal responses to monetary outcomes predict an unwillingness to resist cigarette smoking. Cogn Affect Behav Neurosci. 2014;14:1196–1207.
- Piper, M.E. Withdrawal: Expanding a Key Addiction Construct. Nicotine Tob Res. 2015;17:1405–1415.
- Petry, N.M., O’Brien, C.P. Internet gaming disorder and the DSM-5. Addiction. 2013;108:1186–1187.
- Banz, B.C., Yip, S.W., Yau, Y.H., Potenza, M.N. Behavioral addictions in addiction medicine: from mechanisms to practical considerations. Prog Brain Res. 2016;223:311–328.
- Zhou, Z.H., Yuan, G.Z., Yao, J.J. Cognitive Biases toward Internet Game-Related Pictures and Executive Deficits in Individuals with an Internet Game Addiction. Plos One. 2012;7.
- Decker, S.A., Gay, J.N. Cognitive-bias toward gaming-related words and disinhibition in World of Warcraft gamers. Comput Hum Behav. 2011;27:798–810.
- Zhang, Y., Lin, X., Zhou, H., Xu, J., Du, X., Dong, G. Brain Activity toward Gaming-Related Cues in Internet Gaming Disorder during an Addiction Stroop Task. Frontiers in psychology. 2016;7:714.
- Liu, L., Yip, S.W., Zhang, J.T., Wang, L.J., Shen, Z.J., Liu, B. et al, Activation of the ventral and dorsal striatum during cue reactivity in Internet gaming disorder. Addiction biology. 2016;.
- Carter, B.L., Tiffany, S.T. Meta-analysis of cue-reactivity in addiction research. Addiction. 1999;94:327–340.
- Potenza, M.N., Hong, K.I., Lacadie, C.M., Fulbright, R.K., Tuit, K.L., Sinha, R. Neural correlates of stress-induced and cue-induced drug craving: influences of sex and cocaine dependence. The American journal of psychiatry. 2012;169:406–414.
- Kosten, T.R., Scanley, B.E., Tucker, K.A., Oliveto, A., Prince, C., Sinha, R. et al, Cue-induced brain activity changes and relapse in cocaine-dependent patients. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2006;31:644–650.
- Volkow, N.D., Li, T.K. Drug addiction: the neurobiology of behaviour gone awry. Nature reviews Neuroscience. 2004;5:963–970.
- Balodis, I.M., Potenza, M.N. Anticipatory reward processing in addicted populations: a focus on the monetary incentive delay task. Biological psychiatry. 2015;77:434–444.
- Blum, K., Sheridan, P.J., Wood, R.C., Braverman, E., Chen, T.J., Cull, J. et al, The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med. 1996;:89.
- Trick, L., Kempton, M.J., Williams, S.C.R., Duka, T. Impaired fear recognition and attentional set-shifting is associated with brain structural changes in alcoholic patients. Addiction biology. 2014;19:1041–1054.
- Chaplin, T.M., Hong, K., Fox, H.C., Siedlarz, K.M., Bergquist, K., Sinha, R. Behavioral arousal in response to stress and drug cue in alcohol and cocaine addicted individuals versus healthy controls. Hum Psychopharmacol. 2010;25:368–376.
- Smith, D.G., Simon Jones, P., Bullmore, E.T., Robbins, T.W., Ersche, K.D. Enhanced orbitofrontal cortex function and lack of attentional bias to cocaine cues in recreational stimulant users. Biological psychiatry. 2014;75:124–131.
- Desai, R.A., Krishnan-Sarin, S., Cavallo, D., Potenza, M.N. Video-Gaming Among High School Students: Health Correlates, Gender Differences, and Problematic Gaming. Pediatrics. 2010;126:E1414–E1424.
- Kuss, D.J., Griffiths, M.D. Internet gaming addiction: A systematic review of empirical research. International Journal of Mental Health and Addiction. 2012;10:278–296.
- Griffiths, M.D. The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction. 2010;8:119–125.
- King, D.L., Delfabbro, P.H., Zajac, I.T. Preliminary validation of a new clinical tool for identifying problem video game playing. International Journal of Mental Health and Addiction. 2011;9:72–87.
- Starcke, K., Schlereth, B., Domass, D., Scholer, T., Brand, M. Cue reactivity towards shopping cues in female participants. J Behav Addict. 2013;2:17–22.
- Courtney, K.E., Schacht, J.P., Hutchison, K., Roche, D.J., Ray, L.A. Neural substrates of cue reactivity: association with treatment outcomes and relapse. Addiction biology. 2016;21:3–22.
- Noori, H.R., Cosa Linan, A., Spanagel, R. Largely overlapping neuronal substrates of reactivity to drug, gambling, food and sexual cues: A comprehensive meta-analysis. Eur Neuropsychopharmacol. 2016;26:1419–1430.
- Kuhn, S., Gallinat, J. Common biology of craving across legal and illegal drugs – a quantitative meta-analysis of cue-reactivity brain response. The European journal of neuroscience. 2011;33:1318–1326.
- Chase, H.W., Eickhoff, S.B., Laird, A.R., Hogarth, L. The neural basis of drug stimulus processing and craving: an activation likelihood estimation meta-analysis. Biological psychiatry. 2011;70:785–793.
- Boswell, R.G., Kober, H. Food cue reactivity and craving predict eating and weight gain: a meta-analytic review. Obes Rev. 2016;17:159–177.
- Kober, H., Mende-Siedlecki, P., Kross, E.F., Weber, J., Mischel, W., Hart, C.L. et al, Prefrontal-striatal pathway underlies cognitive regulation of craving. Proceedings of the National Academy of Sciences of the United States of America. 2010;107:14811–14816.
- Goldstein, R.Z., Volkow, N.D. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. The American journal of psychiatry. 2002;159:1642–1652.
- Jentsch, J.D., Taylor, J.R. Impulsivity
resulting from frontostriatal dysfunction in drug abuse: implications
for the control of behavior by reward-related stimuli. Psychopharmacology (Berl). 1999;146:373–390.
- Hartwell, K.J., Johnson, K.A., Li, X., Myrick, H., LeMatty, T., George, M.S. et al, Neural correlates of craving and resisting craving for tobacco in nicotine dependent smokers. Addiction biology. 2011;16:654–666.
- Lubman, D.I., Yucel, M., Pantelis, C. Addiction, a condition of compulsive behaviour? Neuroimaging and neuropsychological evidence of inhibitory dysregulation. Addiction. 2004;99:1491–1502.
- Subramaniyan, M., Dani, J.A. Dopaminergic and cholinergic learning mechanisms in nicotine addiction. Annals of the New York Academy of Sciences. 2015;1349:46–63.
- Lecrubier, Y., Sheehan, D.V., Weiller, E., Amorim, P., Bonora, I., Harnett Sheehan, K. et al, The
Mini International Neuropsychiatric Interview (MINI). A short
diagnostic structured interview: reliability and validity according to
the CIDI. European Psychiatry. 1997;12:224–231.
- Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J. An Inventory for Measuring Depression. Arch Gen Psychiatry. 1961;4:561–571.
- Young, K.S. Internet Addiction Test. 2009; (IAT).
- Petry, N.M., Rehbein, F., Gentile, D.A., Lemmens, J.S., Rumpf, H.J., Mossle, T. et al, An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction. 2014;109:1399–1406.
- Widyanto, L., McMurran, M. The psychometric properties of the internet addiction test. Cyberpsychology & behavior : the impact of the Internet, multimedia and virtual reality on behavior and society. 2004;7:443–450.
- Widyanto, L., Griffiths, M.D., Brunsden, V. A psychometric comparison of the Internet Addiction Test, the Internet-Related Problem Scale, and self-diagnosis. Cyberpsychology, behavior and social networking. 2011;14:141–149.
- Dong, G., Hu, Y., Lin, X., Lu, Q. What
makes Internet addicts continue playing online even when faced by
severe negative consequences? Possible explanations from an fMRI study. Biological psychology. 2013;94:282–289.
- DeVito, E.E., Worhunsky, P.D., Carroll, K.M., Rounsaville, B.J., Kober, H., Potenza, M.N. A preliminary study of the neural effects of behavioral therapy for substance use disorders. Drug and alcohol dependence. 2012;122:228–235.
- Krishnan-Sarin, S., Balodis, I.M., Kober, H., Worhunsky, P.D., Liss, T., Xu, J.S. et al, An
Exploratory Pilot Study of the Relationship Between Neural Correlates
of Cognitive Control and Reduction in Cigarette Use Among
Treatment-Seeking Adolescent Smokers. Psychology of Addictive Behaviors. 2013;27:526–532.
- Ikemoto, S., Yang, C., Tan, A. Basal ganglia circuit loops, dopamine and motivation: A review and enquiry. Behavioural brain research. 290. ; 2015:17–31.
- Cheng, Y., Huang, C.C., Ma, T., Wei, X., Wang, X., Lu, J. et al, Distinct Synaptic Strengthening of the Striatal Direct and Indirect Pathways Drives Alcohol Consumption. Biological psychiatry. 2016;.
- Fineberg, N.A., Chamberlain, S.R., Goudriaan, A.E., Stein, D.J., Vanderschuren, L.J., Gillan, C.M. et al, New developments in human neurocognition: clinical, genetic, and brain imaging correlates of impulsivity and compulsivity. CNS Spectr. 2014;19:69–89.
- Worhunsky, P.D., Malison, R.T., Rogers, R.D., Potenza, M.N. Altered
neural correlates of reward and loss processing during simulated
slot-machine fMRI in pathological gambling and cocaine dependence. Drug Alcohol Depend. 2014;145:77–86.
- Balodis, I.M., Kober, H., Worhunsky, P.D., Stevens, M.C., Pearlson, G.D., Potenza, M.N. Attending to striatal ups and downs in addictions. Biological psychiatry. 2012;72:e25–e26.
- Ko, C.H., Liu, G.C., Hsiao, S., Yen, J.Y., Yang, M.J., Lin, W.C. et al, : Brain activities associated with gaming urge of online gaming addiction. Journal of psychiatric research. 2009;43:739–747.
- Sun, Y., Ying, H., Seetohul, R.M., Xuemei, W., Ya, Z., Qian, L. et al, Brain fMRI study of crave induced by cue pictures in online game addicts (male adolescents). Behavioural brain research. 2012;233:563–576.
- Cavanna, A.E., Trimble, M.R. The precuneus: a review of its functional anatomy and behavioural correlates. Brain : a journal of neurology. 2006;129:564–583.
- Potenza, M.N., Sofuoglu, M., Carroll, K.M., Rounsaville, B.J. Neuroscience of behavioral and pharmacological treatments for addictions. Neuron. 2011;69:695–712.
- Griffiths, M.D., van Rooij, A.J., Kardefelt-Winther, D., Starcevic, V., Kiraly, O., Pallesen, S. et al, Working
towards an international consensus on criteria for assessing internet
gaming disorder: a critical commentary on Petry et al. (2014). Addiction. 2016;111:167–175.